REQUEST - Kick-Off Session
Please fill out this short questionnaire. Once you submit it, you will hear from me via email.
!!Make sure to check your inbox in the next 48 hours!!
I look forward to talking with you soon,
~ Stella Loichot
Certified Health & Lifestyle Coach, Specializing in PreDiabetes Reversal and Weight Management
Allons-y Coaching, LLC -
PS: Except as required by law, all information you share with me will be held confidential unless you state otherwise in writing. For medical advice, diagnosis, and treatment, I encourage you to contact your physician. I am not providing such services.
How did you hear about me?
In 2-3 sentences, please describe the problem or struggle you are experiencing. Be as specific as possible.
In 2-3 sentences, please describe your ideal outcome/goal in the next 6 months.
What programs or systems have you tried in the past to get the results you desire?
In 2-3 sentences please tell me why you believe you haven’t been successful in reaching your goals in the past.
What do you think would make your journey easier?
What are you hoping to get from a consultation with me?
On a scale from 1 to 10, how committed are you to work toward your goals?
I think I want to try...
It's almost a question of life and death!
Do you want FREE support?
I regularly create recipes, checklists, I write articles, lists of tips, videos, and that kind of stuff to help "my people" in their health journey. If you want to receive those resources, join my insider list. I do it all myself, so you won't get spammed. You can expect an email from me about once a week!
Yes, please, sign me up!
No thank you, I don't want to receive tips
Congrats, you just took a big step forward!
Send me a copy of my responses.
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service